Optic nerve avulsion from door-handle trauma in children

Area of Science:

• Ophthalmology
• Pediatric Trauma
• Optic Nerve Injuries

Background:

• Door-handle injuries are a recognized cause of pediatric ocular trauma.
• Optic nerve avulsion (ONA) is a severe consequence of blunt ocular trauma.

Purpose of the Study:

• To investigate the incidence and outcomes of severe visual loss resulting from optic nerve avulsion (ONA) in children with door-handle trauma.
• To analyze the clinical presentation, diagnostic methods, and management of ONA in this pediatric population.

Main Methods:

• Retrospective review of clinical records of 14 children treated for door-handle ocular trauma.
• Analysis of patient demographics, trauma circumstances, presenting symptoms, visual acuity, diagnostic findings (clinical and imaging), interventions, and final visual outcomes.
• Histopathological confirmation in enucleated eyes.

Main Results:

• 14 children (11 male, 3 female, average age 8 years) sustained door-handle trauma.
• Presenting visual acuity was light perception (LP) in 5 and no light perception (NLP) in 9; all had ONA.
• Final visual acuity was LP in 1 and NLP in 13; 8 eyes required enucleation due to pain or for cosmetic reasons.

Conclusions:

• Optic nerve avulsion (ONA) is a primary cause of severe visual loss in children experiencing door-handle ocular trauma.
• Door-handle injuries can lead to devastating and permanent vision impairment, often requiring enucleation.